title: Trends in incidence, management, and survival of gastric and cardia carcinomas in the area of Finistere (France) between 1984 and 2003.
abstract: OBJECTIVE
  The aim of this study was to evaluate trends in incidence and prognosis of gastric and cardia carcinomas in the area of Finistère (France) between 1984 and 2003.
  
  
  METHODS
  The Digestive Tumor Registry of Finistère recorded all new cases of gastric and cardia carcinomas from January 1, 1984 to December 31, 2003. Raw incidence data were standardized using the direct method based on the reference world population. The data and survival rates were studied in univariate and multivariate analyses.
  
  
  RESULTS
  Between 1984-1988 and 1999-2003 the standardized incidence of distal gastric carcinomas decreased (10.74 ± 0.39-5.68 ± 0.27/year/100 000 inhabitants, P < 0.001). There was no significant increase in the incidence of cardia carcinomas (0.83 ± 0.11-1.25 ± 0.14/year/100 000 inhabitants). The frequency of macroscopically infiltrating tumors doubled (P < 0.001) and linitis plastica increased from 9 to 16.2% (P < 0.001). Overall survival rates increased only for patients with metastatic carcinomas of both locations (P < 0.001) and with advanced tumors of distal stomach (P < 0.001) receiving therapy.
  
  
  CONCLUSIONS
  This study showed a significant decrease over time in the incidence of distal gastric carcinomas but no significant increase in the incidence of cardia carcinomas. Despite improvement in the management of patients, prognosis remains dismal, probably because of an increased incidence of poor prognosis of histological and anatomical types.
authors.affiliation: Department of Hepato-Gastroenterology, Brest University Hospital of Finistère, Brest, France. julien.jezequel@chu-brest.fr
authors.forename: Julien
authors.initials: J
authors.lastname: Jézéquel
authors.forename: Christophe
authors.initials: C
authors.lastname: Bessaguet
authors.forename: Cedric
authors.initials: C
authors.lastname: Verveur
authors.forename: Joseph
authors.initials: J
authors.lastname: Faycal
authors.forename: Zoe
authors.initials: Z
authors.lastname: Richert
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Metges
authors.forename: Alain
authors.initials: A
authors.lastname: Volant
authors.forename: Jean-Baptiste
authors.initials: JB
authors.lastname: Nousbaum
authors.forename: Michel
authors.initials: M
authors.lastname: Robaszkiewicz
mesh_terms: D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology / Q000628:therapy; D002299:Cardia / Q000473:pathology / Q000601:surgery; D016009:Chi-Square Distribution; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D016017:Odds Ratio; D016016:Proportional Hazards Models; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D017678:Sex Distribution; D012737:Sex Factors; D013274:Stomach Neoplasms / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology / Q000628:therapy; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult